I have known for a long time that I want to work as a registered nurse who provides compassionate care to vulnerable patient populations. With an intellectual background in Gender, Women and Sexuality Studies, I entered the healthcare field with a goal to serve women and LGBTQ patients. Shortly after starting my prerequisite courses three years ago, I was awarded a competitive position as a medical assistant apprentice at Virginia Mason Medical Center, training under a certified medical assistant. I sought to gain clinical experience in order to learn more about myself on my pathway to nursing. I was excited to be immersed in a diverse healthcare setting, quickly gaining experience in Pediatrics, Gynecology, Adult Primary Care and Dermatology. Two months before my medical assistant certification exam, a terrible tragedy shifted my aspirations as a future nurse. My aunt, who was also my neighbor, lifelong friend, mentor, and a vibrant local artist, abruptly went missing after a precipitous and acute episode of depression that she attributed to menopause. She was found dead by suicide. Remembering this 24-hour event is devastating. Pain remains in my heart while time keeps moving. As aching as this loss is, my experience opened a window through which I am more able to empathize with patients. While painful, my perspective has been enriched, my naivety has been stripped away, and I seek to use my insight to compassionately serve each patient under my care. I now understand how axes of physical health intersect with anxiety, depression, bipolar, and substance abuse. Often in medicine, mental illness remains abstract. While providers can use diagnostic testing to determine a prognosis for physical illness, there are gaps in understanding and treating mental illnesses. I have noticed that many patients who seek treatment for depression try out multiple SSRI medications before finding one that works for them. When my aunt became severely depressed, she was prescribed an antidepressant that caused paranoia, insomnia, and intrusive thoughts. The second medication she tried sparked so much internal turmoil that she was sent to an inpatient psychiatric unit, eliciting trauma rather than healing. From my perspective, our healthcare system failed my aunt, ultimately leading to her death. As a nurse, I want to make a difference for patients who struggle with suicidal ideation, depression and anxiety. And hopefully, I can contribute to the kind of care that my aunt needed when she was sick. I strive to make an impact by treating each patient with objectivity, kindness, dignity, and utmost respect. Registered nurses act as counselors, social workers, and healers, often spending more time with the patient than the provider does. I am committed to doing my best in each of these roles so that I can help people find their way out of a mental or physical prison. My experience as a certified medical assistant intertwines with my ability to live with grief, inspiring me to continue growing into the best person I can be.

I am engulfed in a wave of excitement and nervousness as I anticipate starting UW’s Accelerated Bachelor of Science in Nursing Program this fall. Many experiences along the way have prepared me for nursing school, but the one that stands out the most to me is my involvement in starting Glo’s Community Meals Program in 2018 to address food insecurity in Seattle. As a server at Glo’s, a 24-hour restaurant in Seattle’s vibrant, socioeconomically diverse Capitol Hill neighborhood, I noticed a need for basic resources in my community. I wanted to help address local food instability by creating a community meals program at our restaurant to aid people experiencing homelessness and inequality based upon disability, gender, sexuality, ethnicity, race, mental illness, and socioeconomic status. With support from the owners of Glo’s, I collaborated with two coworkers to develop a donation-based meals program. With voluntary customer contributions, we would create a meal ticket for each donation, and folks in need could come up to our window to order a pre-paid meal. Implementing this program vastly shifted my role at Glo’s. Many community meals patrons grappled with mental illness and trauma, which required me to use skills in de-escalation and emergency response. I set boundaries, actively listened, and remained calm when folks were experiencing internal stimuli or outbursts. I balanced a responsibility to advocate for vulnerable populations with a duty to perform as an excellent server, gracefully managing a full restaurant with twelve tables. Working professionally on a team to help people in need of basic resources inspired me to continue pursuing a career in nursing. I currently work in a hospital as a certified medical assistant where I routinely utilize skills gained during my time at Glo’s. One of the biggest challenges in my day is taking care of patients who struggle with mental illnesses that cause internal stimuli, suffering, and lapses in communication. Recently, I helped a patient who was convinced that someone was sneaking into her apartment to give her filler injections against her will. This patient had a confirmed underlying diagnosis that helped me understand the differences between her perception and mine. During interactions like these, I draw from skills I learned in the Community Meals Program — practicing empathy, patience, harm reduction and de-escalation. Helping someone feel heard creates a sense of belonging and respect. After listening to this patient’s experience, I coordinated care with a nurse to help her access resources in Psychiatry and Primary Care. To me, giving back means being objective, respectful, patient, and utterly kind to every person I interact with. Making connections with those who are otherwise left behind in society is important to me. As a nurse, I want to serve a diverse, vulnerable patient population and help those who are particularly grappling with mental illness, food and housing insecurity. Serving people who live outside via the Community Meals Program taught me invaluable skills in empathy and selflessness. My goal is to continue applying these values in my career and daily life.

One day toward the end We went sledding down a hill I could see your breath Like steam The warmth reassured me You are a great love Passion simmering and shaking That is enough To hold this together I kept my eye on the peak Gleamed in golden light Orange and pink backdrop Peaceful as night, for a moment Then tension builds again Until it breaks You're screaming like a kettle Words burning my skin Sinking in Until there is a lump in my chest And my heart aches I bargain and plea I can live in pain If you'll love me If you'll change The lump swells If only I could have it surgically removed So that we can be together But it remains Swelling, growing Later when I am broken And you have left me I carry my heart dripping red Leaving drops in the snow Like stepping stones

I have alopecia areata, challenging me to accept uncertainty-- an inherent part of life. Three years ago, I found a bald spot on the back of my head. When I went to an internist, she told me not to worry -- just keep an eye on it, and it will probably resolve. Over 3 months, the spot of hair loss grew and grew. Eventually, I could not hide it anymore. Almost one-third of my hair was gone. This abrupt change in my appearance completely shifted my identity. I remember going to Thanksgiving with extended family and being stared at. My aunt gawked, telling me a story about a college friend who lost all of his hair and stuck quarters to his head as a party trick. A friend at work seemed to attempt to comfort me, talking closely and gently rubbing my back. Before I knew it, she was telling me that the night before she'd asked her husband if he'd still be attracted to her if she lost all of her hair. People who cared about me didn't seem to know what to say. It was alienating. Losing so much hair -- and not knowing when a bald spot would pop up, or how large it would grow -- caused me to grapple with feminity and gender. As a woman, I feel expected to be pretty and thus desirable. Messages surround us in advertising and media, trying to sell us products that enhance our beauty, inferring that buying certain things will improve our appearances and therefore our happiness in life. Being a woman and being beautiful are intertwined in the representation of female sexuality, identity, gender, love, and acceptance in many cultural norms. Suddenly, I felt like there was something wrong with me. I could no longer be desired, worthy, or normal again. On the other hand, I felt shallow for feeling unattractive-- for caring about what I looked like. After all, there were patients at work who were struggling with life-threatening diseases. I felt like my problem was trivial compared to cancer or rheumatoid arthritis, for example. There is so much suffering in this world. I told myself I could move beyond this hair loss and reframe my perspective. I am a pre-nursing student and certified medical assistant. After I developed alopecia areata, I started working as a Dermatology Technician. In my role, I feel empowered to treat each patient grappling with hair loss with dignity, respect, and true kindness. Having alopecia areata causes cycles of debilitating anxiety for me, but at work, it's my job to step outside of myself and put the patient first. I've turned this prognosis into a strength by challenging expectations of female beauty not only through personal interactions but through art. Outside of work, I write songs on guitar about what it means to be a woman. Before losing my hair, I thought I was a feminist who challenges social norms, but by paying such close attention to these messages about female beauty, perhaps I was buying into them in terms of my own identity. Working in medicine as a future nurse and MA-C while grappling with an autoimmune disease challenges me to look beyond media, and ultimately, to accept loss and uncertainty. No one has complete control of their body. Having alopecia areata has taught me that we must accept ourselves. This condition has also inspired me to continue advocating for and dedicating myself to helping patients grappling with a sickness of any kind.

Racism is insidious and complex. Growing up as a White person in Seattle, I had the privilege to ignore race. In school, learning about the horrors of Japanese internment, slavery of African peoples, and stealing of Indigenous lands deeply disturbed me, but these narratives were framed in the past. When I entered my teenage years, I started realizing how these histories inform our contemporary world. As an adult, I have learned that being anti-racist is a lifelong journey. I am committed to actively listening to people of color and continuously seeking knowledge about cultural experiences different from my own. I am dedicated to identifying racialized microaggressions in social interactions, confronting my internalized biases, and advocating for people of color, even when this is uncomfortable. Applying this to my profession in healthcare, I can see clearly how access to good health is informed by institutionalized racism. I’ve served hundreds of patients in Dermatology over the past nine months, and only a handful of them have been Black, Latino, or Pacific Islander. There are many reasons for the barriers in our system that prevent people of color from seeking care. I recall a patient interaction during my medical assistant apprenticeship that was informed by power imbalances in race. One day, I shadowed a Licensed Practicing Nurse at the Catholic Health Initiatives (CHI) Obstetrics and Birth Center. A young Black woman who was newly pregnant came in for an appointment, and we learned that she did not want to keep her pregnancy and sought termination resources. The LPN swiftly told her that CHI does not offer this service—the patient would need to go elsewhere, and they’d cancel the appointment. The patient seemed frustrated and sad, asserting that she just wanted to know what her options were. The LPN reiterated that CHI does not provide this kind of service, and the patient left. Healthcare professionals do not always respect the bodily autonomy of Black women. This is evident in historical instances of forced sterilization of women of color and present-day providers who don’t take Black patients’ concerns seriously due to racial bias. Taking this into consideration, the LPN could have provided this patient with counseling, a gestation timeline, and a list of institutions that offer termination services. I have learned that the nurse’s role is to provide the patient options counseling as objectively as possible, presenting pathways without bias, while treating her with absolute dignity and respect. If I could go back in time, I would have spoken up to advocate for this. Practicing anti-racism in nursing means considering race while remaining kind and utterly objective, providing care that empowers the patient. In my role as a future nurse, it is important to me to continuously think critically, learn, and self-reflect so that I can meet people where they are in their health across differences in race and ethnicity.